Abstract QS28: Tracking Outcomes in Breast Reduction: An Analysis of 5,917 Patients Using the TOPS Database

Smith, Jeffrey M.; Boukovalas, Stefanos; Hamati, John; Padilla, Pablo L.; Andersen, Clark R.; Park, Julie E.; Phillips, Linda G.

doi:10.1097/01.gox.0000558448.59694.70

Cited by 1 publication

(6 citation statements)

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“…There was no nipple-areola loss, whereas the literature cites a range of 0.5 to 8 percent. 4,6,10,13,14,[24][25][26]29,40 Our total infection rate of 4 percent with a reoperation for this complication of 2 percent was consistent with that reported in the literature, which ranged from 1.2 to 34.4 percent. [4][5][6][9][10][11][12][13][14][17][18][19]29,31,[33][34][35][36][37][38]40 Again, minor infections may not have been captured by larger meta-analysis.…”

Section: Discussionsupporting

confidence: 90%

“…This review revealed a wide variation in the reporting of patient numbers, the grading of complications, outcomes, and length of follow-up. 1–6,9–40 Total complication rates varied from 4.5 to 57 percent, 1,3–6,9–14,17–35 and major complications ranged from 0.5 to 23 percent. 1,4,10–14,22,24,27,29,30,33–36 Although our complication rate of 65 percent may seem high in relation to the published literature, what we have presented is a complete evaluation of all complications, even the smallest amount of skin breakdown.…”

Section: Discussionmentioning

confidence: 99%

“…Our total infection rate of 4 percent with a reoperation for this complication of 2 percent was consistent with that reported in the literature, which ranged from 1.2 to 34.4 percent. 4–6,9–14,17–19,29,31,33–38,40 Again, minor infections may not have been captured by larger meta-analysis. 2,15–17…”

Section: Discussionmentioning

confidence: 99%

“…One article compared body surface area (BSA). [1][2][3][4][5][6][9][10][11][12][13][14][15][16][17][19][20][21][22][23][24][25][26][27][28][29][30][32][33][34][35][36][37][38][39][40][41][42] These studies were evaluated and compared with the current studies' outcomes (see Discussion section), http://links.lww.com/PRS/F333.] We differ, however, in the statistical influence of nicotine on outcome, although there was a trend toward wound healing complications that did not reach significance (Table 7).…”

Section: Discussionmentioning

confidence: 99%

“…There was no nipple-areola loss, whereas the literature cites a range of 0.5 to 8 percent. 4,6,10,13,14,24–26,29,40…”

Section: Discussionmentioning

confidence: 99%

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A Statistical Analysis of The Effects of Comorbidities on the Inferior Pedicle Reduction Mammaplasty; Are there premorbid conditions which prohibit this procedure?

Friedman

Schlub

Durkin

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Multiple studies have analyzed the impact of comorbidities on breast reduction surgery with mixed results. The purpose of this investigation was to perform a statistical analysis of all complications by a single surgeon, using a single technique for breast reduction. Methods: Records of patients undergoing breast reduction from 1984 to 2019 with an inferior pedicle were reviewed. Comorbidities analyzed included hypertension, diabetes, nicotine use, weight of breast tissue resected, pedicle length, and basal metabolic index. The literature on the effects of comorbidities on outcomes for breast reconstruction was also reviewed. Results: Although increasing body mass index significantly increased the rate of fat necrosis, it did not impact those patients requiring reoperation for this complication. Body mass index greater than 35 kg/m2, weight of tissue resection greater than 1000 g, and nipple-to–inframammary fold distance greater than 20 cm all increased the odds ratio of having a breast with some fat necrosis. Increasing body mass index increased the risk of wound healing problems (both major and minor), but not for patients requiring reoperation. Body mass index greater than 35 kg/m2, breast tissue resection greater than 1000 g, and nipple-to–inframammary fold distance greater than 20 cm only minimally increased the odds ratio for a major wound complication. Conclusions: Patients with increased body mass index are at greater risk for fat necrosis and wound healing complications. However, these usually can be managed conservatively in patients undergoing inferior pedicle breast reduction. Patients do not require free nipple grafting. The use of nicotine or the presence of diabetes or hypertension does not impact outcome. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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